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Kumar R, Kumar R, Goel H, Kumar S, Ningombam SS, Haider I, Agrawal U, Deo S, Gogia A, Batra A, Sharma A, Mathur S, Ranjan A, Chopra A, Hussain S, Tanwar P. Whole exome sequencing identifies novel variants of PIK3CA and validation of hotspot mutation by droplet digital PCR in breast cancer among Indian population. Cancer Cell Int 2023; 23:236. [PMID: 37821962 PMCID: PMC10568783 DOI: 10.1186/s12935-023-03075-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 09/20/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND Breast cancer (BC) is the most common malignancy with very high incidence and relatively high mortality in women. The PIK3CA gene plays a pivotal role in the pathogenicity of breast cancer. Despite this, the mutational status of all exons except exons 9 and 20 still remains unknown. METHODS This study uses the whole exome sequencing (WES) based approach to identify somatic PIK3CA mutations in Indian BC cohorts. The resultant hotspot mutations were validated by droplet digital PCR (ddPCR). Further, molecular dynamics (MD) simulation was applied to elucidate the conformational and functional effects of hotspot position on PIK3CA protein. RESULTS In our cohort, PIK3CA showed a 44.4% somatic mutation rate and was among the top mutated genes. The mutations of PIK3CA were confined in Exons 5, 9, 11, 18, and 20, whereas the maximum number of mutations lies within exons 9 and 20. A total of 9 variants were found in our study, of which 2 were novel mutations observed on exons 9 (p.H554L) and 11 (p.S629P). However, H1047R was the hotspot mutation at exon 20 (20%). In tumor tissues, there was a considerable difference between copy number of wild-type and H1047R mutant was detected by ddPCR. Significant structural and conformational changes were observed during MD simulation, induced due to point mutation at H1047R/L position. CONCLUSIONS The current study provides a comprehensive view of novel as well as reported single nucleotide variants (SNVs) in PIK3CA gene associated with Indian breast cancer cases. The mutation status of H1047R/L could serve as a prognostic value in terms of selecting targeted therapy in BC.
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Affiliation(s)
- Rahul Kumar
- Dr B. R. A.-Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Rakesh Kumar
- Dr B. R. A.-Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Harsh Goel
- Dr B. R. A.-Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Sonu Kumar
- Department of Gastroenterology & HNU, All India Institute of Medical Sciences, New Delhi, India
| | - Somorjit Singh Ningombam
- Dr B. R. A.-Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Imran Haider
- Dr B. R. A.-Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Usha Agrawal
- National Institute of Pathology, New Delhi, India
| | - Svs Deo
- Dr B. R. A.-Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Ajay Gogia
- Dr B. R. A.-Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Atul Batra
- Dr B. R. A.-Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Ashok Sharma
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, India
| | - Sandeep Mathur
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Amar Ranjan
- Dr B. R. A.-Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Anita Chopra
- Dr B. R. A.-Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Showket Hussain
- Division of Molecular Oncology, National Institute of Cancer Prevention and Research, Noida, India
| | - Pranay Tanwar
- Dr B. R. A.-Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India.
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Sharma RK, Gogia A, Deo S, Sharma D, Mathur S, Sagiraju HKR. Dose-dense neoadjuvant chemotherapy in triple-negative breast cancer: Real-world data from a developing country. Indian J Cancer 2023; 60:505-511. [PMID: 38189648 DOI: 10.4103/ijc.ijc_1120_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 04/13/2022] [Indexed: 01/09/2024]
Abstract
BACKGROUND Dose-dense adjuvant chemotherapy has been shown to be associated with improved long-term survival outcomes in triple-negative breast cancer (TNBC). However, there is a lacuna of data on the benefits of dose-dense neoadjuvant chemotherapy (NACT) in TNBC. METHODS This retrospective study included 217 newly diagnosed cases of TNBC treated with a sequential anthracycline and taxane-based NACT, followed by definitive surgery. Study groups consisted of 137 patients who received 3-weekly conventional chemotherapy (cNACT group) and 80 patients with 2-weekly dose-dense NACT (ddNACT group). Pathological complete response (pCR) rates, relapse-free survival (RFS), overall survival (OS), and grade-3/4 chemotoxicities were compared across the groups. RESULTS No significant difference in the pCR rate (32.8% versus 31.3%; P = 0.808) was observed across the study groups. Relapse rate was lower in the ddNACT group compared to the cNACT group (odds ratio [OR]: 0.51, 95% confidence interval [CI]: 0.27-0.95). However, ddNACT had no RFS advantage over conventional chemotherapy (median RFS: not reached versus 56.1 months in cNACT; hazard ratio: 0.90, 95% CI: 0.52-1.53). OS was also comparable in both the groups with a 3-year survival rate of 78.8% (95% CI: 60.9-89.2) in the ddNACT group versus 84.3% (95% CI: 74.8-90.4) in the cNACT group. Younger age, menopause, the Eastern Cooperative Oncology Group ECOG status, and pCR were significantly associated with OS in our cohort. Grade-3 toxicities were comparable in both groups. CONCLUSIONS This observational study focusing on ddNACT among TNBC patients demonstrated significant differences in the relapse rate with no survival benefits. Differential effects of ddNACT by tumor presentation (early vs. late), tumor size, tumor biology, and cost-benefits of granulocyte colony-stimulating factor support with such regimens need further exploration.
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Affiliation(s)
- Rakesh Kumar Sharma
- Department of Medical Oncology, Dr. B.R.A. IRCH, All India Institute of Medical Sciences, New Delhi, India
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Deo S, Bansal B, Bhoriwal S, Bal CS, Mishra A, Sharma J, Singh S, Jayakumar P, Agarwal S, Bhatnagar S, Mishra S, Bharati SJ, Kumar V, Thulkar S. Re-operative surgery for differentiated thyroid cancer: A single institutional experience of 182 cases. Eur J Surg Oncol 2023; 49:107042. [PMID: 37634301 DOI: 10.1016/j.ejso.2023.107042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 07/24/2023] [Accepted: 08/20/2023] [Indexed: 08/29/2023]
Abstract
INTRODUCTION Re-operative thyroid surgery (RTS) is performed in patients of differentiated thyroid cancer (DTC) with residual or recurrent disease. However, there is a paucity of literature discussing experience and technique of RTS. This study aims to address this gap by providing a comprehensive review of RTS for DTC, utilizing experiences from a dedicated complex thyroid surgical oncology program at the apex hospital in a developing country. METHODS A retrospective analysis was conducted using data from the Department of Surgical Oncology's thyroid cancer database. The study period spanned from 2006 to 2022. Clinical presentation, prior surgical history, operative details of RTS, and post-operative outcomes were assessed. Descriptive analysis was performed. RESULTS During the study period, a total of 182 patients underwent re-operative thyroid surgery (RTS). The primary surgeries performed prior to RTS included near-total or total thyroidectomy in most cases (69.2%), and approximately half of the patients (48.4%) had prior neck node interventions. The RTS procedures consisted of completion total thyroidectomy in 30.8% of cases and surgery for thyroid bed recurrence in 9.9% of cases, while central node dissection was performed in 46.2% of patients and unilateral or bilateral template neck dissection was performed in 41.8% of cases. Extended resections were required in 9.3% of patients. Post-operative complications included permanent hypoparathyroidism (2.7%) and unilateral recurrent laryngeal nerve palsy (1.6%). CONCLUSIONS RTS is a complex procedure with high rates of post-operative morbidity reported in literature. Optimal outcomes require a multidisciplinary approach, thorough assessment, and skilled surgeons.
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Affiliation(s)
- Svs Deo
- Department of Surgical Oncology, Dr. BRA-IRCH, AIIMS, New Delhi, India.
| | - Babul Bansal
- Department of Surgical Oncology, Dr. BRA-IRCH, AIIMS, New Delhi, India.
| | - Sandeep Bhoriwal
- Department of Surgical Oncology, Dr. BRA-IRCH, AIIMS, New Delhi, India.
| | - C S Bal
- Department of Nuclear Medicine, AIIMS, New Delhi, India.
| | - Ashutosh Mishra
- Department of Surgical Oncology, Dr. BRA-IRCH, AIIMS, New Delhi, India.
| | - Jyoti Sharma
- Department of Surgical Oncology, Dr. BRA-IRCH, AIIMS, New Delhi, India.
| | - Seema Singh
- Department of Surgical Oncology, RGCIRC, New Delhi, India.
| | - P Jayakumar
- Department of Surgical Oncology, Dr. BRA-IRCH, AIIMS, New Delhi, India.
| | | | - Sushma Bhatnagar
- Department of Onco-anesthesia and Palliative Medicine, Dr. BRA-IRCH, AIIMS, New Delhi, India.
| | - Seema Mishra
- Department of Onco-anesthesia and Palliative Medicine, Dr. BRA-IRCH, AIIMS, New Delhi, India.
| | - Sachidanand Jee Bharati
- Department of Onco-anesthesia and Palliative Medicine, Dr. BRA-IRCH, AIIMS, New Delhi, India.
| | - Vinod Kumar
- Department of Onco-anesthesia and Palliative Medicine, Dr. BRA-IRCH, AIIMS, New Delhi, India.
| | - Sanjay Thulkar
- Department of Radiology, Dr. BRA-IRCH, AIIMS, New Delhi, India.
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Kakkar A, Satapathy S, Sikka K, Tanwar P, Deo S, Jain D. Evaluation of high-risk human papillomavirus in sinonasal papillomas and squamous cell carcinomas. Virchows Arch 2023; 483:381-392. [PMID: 37452847 DOI: 10.1007/s00428-023-03601-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 06/26/2023] [Accepted: 07/08/2023] [Indexed: 07/18/2023]
Abstract
The sinonasal tract is considered a second hotspot for human papillomavirus (HPV)-related tumors in the head and neck, with HPV being identified in up to 62% of squamous cell carcinomas (SCCs) and 38% of papillomas. There is limited data from geographical regions with low prevalence of high-risk (HR)-HPV on the association of HR-HPV in sinonasal neoplasms and on utility of p16 as a surrogate marker. p16 immunohistochemistry, HR-HPV mRNA ISH and quantitative real-time PCR (qPCR) were performed on a retrospective cohort of sinonasal papillomas and SCCs. KRAS mutation analysis was done in oncocytic papillomas. p16 positivity was present in 22/142 cases (15.5%) including eight inverted papillomas, one oncocytic papilloma (OP), and 13 SCC. Among these, mRNA ISH showed HR-HPV in the OP and two SCC, while another SCC was found to harbour HPV18 by qPCR. Two HPV-associated SCCs had foci of OP. mRNA ISH was negative in all p16 negative cases. p16 immunohistochemistry showed 68% concordance with mRNA ISH, and had sensitivity and negative predictive value of 100%; specificity was 67%, and positive predictive value was 14.3%. Association with HR-HPV in sinonasal papillomas and SCC is rare, and may be seen in cases demonstrating oncocytic morphology. p16 immunohistochemistry has low specificity and positive predictive value in low-prevalence populations; thus, reflex direct HR-HPV testing should be performed in p16 immunopositive cases. This two-step approach is viable in resource-limited settings, as the proportion of p16 positive cases is small.
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Affiliation(s)
- Aanchal Kakkar
- Department of Pathology, All India Institute of Medical Sciences, 110029, New Delhi, India
| | | | - Kapil Sikka
- Department of Otorhinolaryngology and Head-Neck Surgery, All India Institute of Medical Sciences, 110029, New Delhi, India
| | - Pranay Tanwar
- Department of Laboratory Oncology, All India Institute of Medical Sciences, 110029, New Delhi, India
| | - Svs Deo
- Department of Surgical Oncology, All India Institute of Medical Sciences, 110029, New Delhi, India
| | - Deepali Jain
- Department of Pathology, All India Institute of Medical Sciences, 110029, New Delhi, India.
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Massey S, Khan MA, Rab SO, Mustafa S, Khan A, Malik Z, Shaik R, Verma MK, Deo S, Husain SA. Evaluating the role of MEN1 gene expression and its clinical significance in breast cancer patients. PLoS One 2023; 18:e0288482. [PMID: 37437063 DOI: 10.1371/journal.pone.0288482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 06/27/2023] [Indexed: 07/14/2023] Open
Abstract
BACKGROUND Breast cancer is a multifactorial disease which involves number of molecular factors that are critically involved in proliferation of breast cancer cells. MEN1 gene that is traditionally known for its germline mutations in neuroendocrine tumors is associated with high risk of developing breast cancer in females with MEN1 syndrome. However, the paradoxical role of MEN1 is reported in sporadic breast cancer cases. The previous studies indicate the functional significance of MEN1 in regulating breast cells proliferation but its relevance in development and progression of breast cancer is still not known. Our study targets to find the role of MEN1 gene aberration and its clinical significance in breast cancer. METHODS Breast tumor and adjacent normal tissue of 142 sporadic breast cancer patients were collected at the time of surgery. The expression analysis of MEN1 mRNA and protein was done through RT-PCR, immunohistochemistry and western blotting. Further to find the genetic and epigenetic alterations, automated sequencing and MS-PCR was performed respectively. Correlation between our findings and clinical parameters was determined using appropriate statistical tests. RESULTS MEN1 expression was found to be significantly increased in the breast tumor tissue with its predominant nuclear localization. The elevated expression of MEN1 mRNA (63.38% cases) and protein (60.56% cases) exhibited a significant association with ER status of the patients. Most of the cases had unmethylated (53.52%) MEN1 promoter region, which can be a key factor responsible for dysregulated expression of MEN1 in breast cancer cases. Our findings also revealed the significant association of MEN1 mRNA overexpression with Age and lymph node status of the patients. CONCLUSION Our results indicate upregulated expression of MEN1 in sporadic breast cancer patients and it could be critically associated with development and advancement of the disease.
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Affiliation(s)
- Sheersh Massey
- Human Genetics Laboratory, Department of Biosciences, Jamia Millia Islamia, New Delhi, India
| | - Mohammad Aasif Khan
- Division of Hematology and Medical Oncology, Department of Medicine, University of Texas Health San Science Center at Antonio (UTHSCSA), San Antonio, TX, United States of America
| | - Safia Obaidur Rab
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia
| | - Saad Mustafa
- Human Genetics Laboratory, Department of Biosciences, Jamia Millia Islamia, New Delhi, India
| | - Asifa Khan
- Human Genetics Laboratory, Department of Biosciences, Jamia Millia Islamia, New Delhi, India
| | - Zoya Malik
- Human Genetics Laboratory, Department of Biosciences, Jamia Millia Islamia, New Delhi, India
| | - Rahimunnisa Shaik
- Human Genetics Laboratory, Department of Biosciences, Jamia Millia Islamia, New Delhi, India
| | - Mohit Kumar Verma
- Human Genetics Laboratory, Department of Biosciences, Jamia Millia Islamia, New Delhi, India
| | - Svs Deo
- Department of Surgical Oncology BRA-IRCH, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Syed Akhtar Husain
- Human Genetics Laboratory, Department of Biosciences, Jamia Millia Islamia, New Delhi, India
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Gupta A, Gogia A, Deo S, Sharma DN, Mathur S, Sagiraju HKR. Neoadjuvant chemotherapy with or without anthracyclines in combination with single HER2-targeted therapy in HER2-positive breast cancer. Cancer Treat Res Commun 2023; 36:100741. [PMID: 37453371 DOI: 10.1016/j.ctarc.2023.100741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 05/25/2023] [Accepted: 07/07/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND Neoadjuvant chemotherapy (NACT) with human epidermal growth factor receptor 2 (HER2) blockade is the preferred approach for treating early and locally advanced HER2-positive breast cancer. There is a lack of robust data comparing pathological complete response (pCR) and survival outcomes in anthracycline-free and anthracycline-containing regimens with single HER2-targeted therapy. OBJECTIVES The present study retrospectively evaluated pCR between two groups: Single HER2-targeted therapy with and without anthracycline. METHODS A total of 215 HER2-positive female breast cancer patients were analyzed who received eitheranthracycline-containing EC-TH (epirubicin and cyclophosphamide, followed by docetaxel and trastuzumab)oranthracycline-free TCH [docetaxel, carboplatin and trastuzumab]. Univariate and multivariate analyses identified prognostic factors for survival and pCR.Kaplan Meier survival curvesdetermined disease-free survival(DFS) and overall survival (OS). RESULTS Baseline characteristics were comparable in both treatment groups. The pCR rate was 30.8% in the anthracycline-containing EC-TH group and 40.9% in the anthracycline-free TCH group; p = 0.140. Disease-free survival at 3 years (65.8% vs. 58.4%) and 5 years (49.2% vs. 55.2%) was similar between EC-TH and TCH groups, respectively (log-rank p = 0.550). Three-year (95.5% vs. 92.5%) and five-year (84.4% vs. 80.8%) OSwere also comparable between both groups (log-rank p = 0.485). The anthracycline-containing EC-TH group had a higher incidence of febrile neutropenia (6.4%. vs. 3.6%) and cardiac adverse events (7.7% vs. 4.4%) than the anthracycline-free TCH group. CONCLUSION Neoadjuvant anthracycline-free chemotherapy has similar pCR and survival outcomeswith favourable cardiac and non-cardiac adverse effect profiles compared with anthracycline-containing chemotherapy.
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Affiliation(s)
- Anshul Gupta
- All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Ajay Gogia
- All India Institute of Medical Sciences (AIIMS), New Delhi, India.
| | - Svs Deo
- All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - D N Sharma
- All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Sandip Mathur
- All India Institute of Medical Sciences (AIIMS), New Delhi, India
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Akhtar MS, Akhter N, Talat A, Alharbi RA, Sindi AAA, Klufah F, Alyahyawi HE, Alruwetei A, Ahmad A, Zamzami MA, Deo S, Husain SA, Badi OA, Khan MJ. Association of mutation and expression of the brother of the regulator of imprinted sites (BORIS) gene with breast cancer progression. Oncotarget 2023; 14:528-541. [PMID: 37235839 DOI: 10.18632/oncotarget.28442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
INTRODUCTION The BORIS, 11 zinc-finger transcription factors, is a member of the cancer-testis antigen (CTA) family. It is mapped to chromosome number 20q13.2 and this region is genetically linked to the early onset of breast cancer. The current study analyzed the correlation between BORIS mutations and the expression of the protein in breast cancer cases. MATERIALS AND METHODS A population-based study including a total of 155 breast cancer tissue samples and an equal number of normal adjacent tissues from Indian female breast cancer patients was carried out. Mutations of the BORIS gene were detected by polymerase chain reaction-single standard confirmation polymorphisms (PCR-SSCP) and automated DNA sequencing and by immunohistochemistry for BORIS protein expression were performed. The observed findings were correlated with several clinicopathological parameters to find out the clinical relevance of associations. RESULTS Of all the cases 16.12% (25/155) showed mutations in the BORIS gene. The observed mutations present on codon 329 are missense, leading to Val> Ile (G>A) change on exon 5 of the BORIS gene. A significant association was observed between mutations of the BORIS gene and some clinicopathological features like nodal status (p = 0.013), estrogen receptor (ER) expression (p = 0.008), progesterone receptor (PR) expression (p = 0.039), clinical stage (p = 0.010) and menopausal status (p = 0.023). The protein expression analysis showed 20.64% (32/155) samples showing low or no expression (+), 34.19% (53/155) with moderate expression (++), and 45.17% (70/155) showing high expression (+++) of BORIS protein. A significant association was observed between the expression of BORIS protein and clinicopathological features like clinical stage (p = 0.013), nodal status (p = 0.049), ER expression (p = 0.039), and PR expression (p = 0.027). When mutation and protein expression were correlated in combination with clinicopathological parameters a significant association was observed in the category of high (+++) level of BORIS protein expression (p = 0.017). CONCLUSION The BORIS mutations and high protein expression occur frequently in carcinoma of the breast suggesting their association with the onset and progression of breast carcinoma. Further, the BORIS has the potential to be used as a biomarker.
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Affiliation(s)
- Mohammad Salman Akhtar
- Department of Basic Medical Sciences, Faculty of Applied Medical Sciences, Al-Baha University, Al-Baha, Saudi Arabia
- Department of Biosciences, Faculty of Natural Sciences, Jamia Millia Islamia, New Delhi, India
| | - Naseem Akhter
- Department of Biosciences, Faculty of Natural Sciences, Jamia Millia Islamia, New Delhi, India
- Department of Neurology, Henry Ford Health System, Detroit, MI 48202, USA
| | - Arshi Talat
- Department of Orthodontics and Dentofacial Orthopedics, ITS Dental College, Hospital and Research Centre, Greater Noida, Delhi-NCR, India
| | - Raed A Alharbi
- Department of Laboratory Medicine, Faculty of Applied Medical Sciences, Al-Baha University, Al-Baha, Saudi Arabia
| | - Abdulmajeed A A Sindi
- Department of Basic Medical Sciences, Faculty of Applied Medical Sciences, Al-Baha University, Al-Baha, Saudi Arabia
| | - Faisal Klufah
- Department of Laboratory Medicine, Faculty of Applied Medical Sciences, Al-Baha University, Al-Baha, Saudi Arabia
| | - Hanan E Alyahyawi
- Department of Laboratory Medicine, Faculty of Applied Medical Sciences, Al-Baha University, Al-Baha, Saudi Arabia
| | - Abdulmohsen Alruwetei
- Department of Medical Laboratory, College of Applied Medical Sciences, Qassim University, Qassim, Saudi Arabia
| | - Abrar Ahmad
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mazin A Zamzami
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Svs Deo
- Department of Surgical Oncology, BRA- IRCH, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Syed Akhtar Husain
- Department of Biosciences, Faculty of Natural Sciences, Jamia Millia Islamia, New Delhi, India
| | - Osama A Badi
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia
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Gamit P, Saikia J, Malik P, Kumar S, Jain D, Madan K, Bharati S, Deo S, Kumar S. PP01.23 Outcomes of Stage IIIA Disease in NSCLC, Treated with Surgery - A Single Institution Experience. J Thorac Oncol 2023. [DOI: 10.1016/j.jtho.2022.09.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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Kar A, Medatwal N, Rajput K, Mandal S, Pani T, Khan A, Sharma P, Oberoi AS, Vishwakarma G, Deo S, Jolly MK, Bajaj A, Dasgupta U. Unique sphingolipid signature identifies luminal and triple-negative breast cancer subtypes. Int J Cancer 2023; 152:2410-2423. [PMID: 36602287 DOI: 10.1002/ijc.34423] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 12/06/2022] [Accepted: 12/12/2022] [Indexed: 01/06/2023]
Abstract
Breast cancer (luminal and triple-negative breast cancer [TNBC]) is the most common cancer among women in India and worldwide. Altered sphingolipid levels have emerged as a common phenomenon during cancer progression. However, these alterations are yet to be translated into robust diagnostic and prognostic markers for cancer. Here, we present the quantified sphingolipids of tumor and adjacent-normal tissues from patients of luminal (n = 70) and TNBC (n = 42) subtype from an Indian cohort using targeted liquid chromatography mass spectrometry. We recorded unique sphingolipid profiles that distinguished luminal and TNBC tumors in comparison to adjacent normal tissue by six-sphingolipid signatures. Moreover, systematic comparison of the profiles of luminal and TNBC tumors provided a unique five-sphingolipid signature distinguishing the two subtypes. We further identified key sphingolipids that can stratify grade II and grade III tumors of luminal and TNBC subtype as well as their lymphovascular invasion status. Therefore, we provide the right evidence to develop these candidate sphingolipids as widely acceptable marker/s capable of diagnosing luminal vs TNBC subtype of breast cancer, and predicting the disease severity by identifying the tumor grade.
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Affiliation(s)
- Animesh Kar
- Laboratory of Nanotechnology and Chemical Biology, Regional Centre for Biotechnology, NCR Biotech Science Cluster, Faridabad, Haryana, India
| | - Nihal Medatwal
- Amity Institute of Integrative Sciences and Health, Amity University Haryana, Gurgaon, Haryana, India
| | - Kajal Rajput
- Amity Institute of Integrative Sciences and Health, Amity University Haryana, Gurgaon, Haryana, India
| | - Susmita Mandal
- Centre for BioSystems Science and Engineering, Indian Institute of Science, Bangalore, India
| | - Trishna Pani
- Amity Institute of Integrative Sciences and Health, Amity University Haryana, Gurgaon, Haryana, India
| | - Ali Khan
- Amity Institute of Integrative Sciences and Health, Amity University Haryana, Gurgaon, Haryana, India
| | - Pankaj Sharma
- Amity Institute of Integrative Sciences and Health, Amity University Haryana, Gurgaon, Haryana, India
| | - Ajit Singh Oberoi
- Department of Surgical Oncology, BRA-Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Gayatri Vishwakarma
- Department of Biostatistics, Indian Spinal Injuries Centre, New Delhi, India.,The George Institute of Global Health, New Delhi, India
| | - Svs Deo
- Department of Surgical Oncology, BRA-Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Mohit Kumar Jolly
- Centre for BioSystems Science and Engineering, Indian Institute of Science, Bangalore, India
| | - Avinash Bajaj
- Laboratory of Nanotechnology and Chemical Biology, Regional Centre for Biotechnology, NCR Biotech Science Cluster, Faridabad, Haryana, India
| | - Ujjaini Dasgupta
- Amity Institute of Integrative Sciences and Health, Amity University Haryana, Gurgaon, Haryana, India
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Kumar N, Deo S, Bhoriwal S, Mondal A, Sharma A, Pramanik R, Kumar R, Kumar S. MO21-2 Correlation of response following NACT between FDG PETCT and TRG in SCC of esophagus: A prospective study. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.05.150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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11
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Mohan P, Chang D, Deo S, Liu Z, Kaneku H, Jalaeian H, Dikici E, Zeynaloo E, Velazquez O, Bhatia S, Daunert S. Abstract No. 358 Liver regeneration following thermal ablation using targeted nanocarrier mediated stem cell therapy. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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12
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Koris J, Deo S. Parental acceptability of pediatric forearm manipulations in a UK district hospital emergency department. J Child Orthop 2022; 16:98-103. [PMID: 35620126 PMCID: PMC9127884 DOI: 10.1177/18632521221084176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 02/07/2022] [Indexed: 02/03/2023] Open
Abstract
PURPOSE Pediatric forearm fractures are a common presentation to Accident and Emergency departments. Standard treatment for the majority of these is manipulation under sedation within the department, followed by cast application. Concerns have been raised about the acceptability of such interventions, and reluctance to perform these procedures has led to increased admissions and manipulations performed under general anesthetic. METHODS A prospective case series of all pediatric patients with forearm fractures who underwent a manipulation under sedation in the Accident and Emergency department was collected over 12 months. All parents were invited to complete an acceptability questionnaire, adapted from the Swedish Pyramid Questionnaire for Treatment, based on their experiences. RESULTS A total of 77 patients were included and their parents were asked to complete a Swedish Pyramid Questionnaire of Treatment. Forty-four parents (55%) agreed to fill out the questionnaire. Patient demographics and fracture characteristics were compared between the group that responded and those that did not, with no significant differences. Average level of satisfaction was 9.4/10 (range = 7-10). 98% of respondents were satisfied with the level of analgesia provided, but only 86% with the timeliness of administration. CONCLUSION This parent-focused evaluation of treatment confirms high levels of parental satisfaction with the management of pediatric forearm fractures in Accident and Emergency, with regard to care, analgesia, and information. It provides insights about parental concern relating to the injury and their anxiety as information useful to further improving care, a template for assessing quality improvement and should be considered as part of further studies in this field. LEVEL OF EVIDENCE Level IV case series.
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Affiliation(s)
| | - S Deo
- S Deo, Trauma and Orthopaedic Consultant, Great Western Hospital, Marlborough Road, Swindon SN3 6BB, UK.
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Mittal A, Deo S, Gogia A, Batra A, Kumar A, Bhoriwal S, Deb KS, Dhamija E, Thulkar S, Ramprasad VL, Olopade O, Pramanik R. ASO Visual Abstract: Profile of Pathogenic Mutations and Evaluation of Germline Genetic Testing Criteria in Consecutive Breast Cancer Patients Treated at a North Indian Tertiary Care Center. Ann Surg Oncol 2021. [PMID: 34825284 DOI: 10.1245/s10434-021-10967-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Abhenil Mittal
- Department of Medical Oncology, Dr. B. R.A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, 110 029, India
| | - Svs Deo
- Department of Surgical Oncology, Dr. B. R.A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, 110 029, India
| | - Ajay Gogia
- Department of Medical Oncology, Dr. B. R.A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, 110 029, India
| | - Atul Batra
- Department of Medical Oncology, Dr. B. R.A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, 110 029, India
| | - Akash Kumar
- Department of Medical Oncology, Dr. B. R.A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, 110 029, India
| | - Sandeep Bhoriwal
- Department of Surgical Oncology, Dr. B. R.A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, 110 029, India
| | - Koushik Sinha Deb
- Department of Psychiatry, Dr. B. R.A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, 110 029, India
| | - Ekta Dhamija
- Department of Radiodiagnosis, Dr. B. R.A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, 110 029, India
| | - Sanjay Thulkar
- Department of Radiodiagnosis, Dr. B. R.A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, 110 029, India
| | | | - Olufunmilayo Olopade
- Center for Clinical Cancer Genetics and Global Health, University of Chicago, Chicago, USA
| | - Raja Pramanik
- Department of Medical Oncology, Dr. B. R.A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, 110 029, India.
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Pulappadi VP, Paul S, Hari S, Dhamija E, Manchanda S, Kataria K, Mathur S, Mani K, Gogia A, Deo S. Axillary ultrasonography combined with pre-operative wire localisation of clipped node in nodal restaging after neoadjuvant chemotherapy in node positive breast cancer patients: a pilot study. Br J Radiol 2021; 94:20210788. [PMID: 34491822 DOI: 10.1259/bjr.20210788] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE To evaluate the role of axillary ultrasonography (axUS) and ultrasound-guided pre-operative wire localisation of pre-treatment positive clipped node (CN) for prediction of nodal response to neoadjuvant chemotherapy (NACT) in node positive breast carcinoma patients. METHODS AND MATERIALS A prospective study was conducted between June 2018 and August 2020 after Ethics Committee approval. Breast carcinoma patients (cT1-cT4b) with palpable axillary nodes (cN1-cN3) and suitable for NACT were recruited after written informed consent. Single, most suspicious node was biopsied and clipped. Nodal response to NACT was assessed on axUS. Wire localisation of CN was performed prior to axillary lymph node dissection (ALND). Diagnostic performances of axUS and CN excision were assessed. RESULTS Of the 69 patients evaluated, 32 patients (mean age, 43.5 ± 11.8 years; females, 31/32 [97%]; pre-menopausal, 18/32 [56.3%]) with metastatic nodes who received NACT were included. Nodal pathological complete response rate was 34.4% (11/32) overall and 70% (7/10) in patients with ≤2 suspicious nodes on pre-NACT axUS. False-negative rates (FNRs) of axUS and CN excision were 4.8% and 28.6% respectively. Combination of post-NACT axUS and CN excision had an FNR of 4.8% overall and 0% in patients with ≤2 suspicious nodes on pre-NACT axUS. CONCLUSION Combination of AxUS and ultrasound-guided wire localisation of pre-treatment positive CN has high diagnostic accuracy for nodal restaging after NACT in node positive breast cancer patients. ADVANCES IN KNOWLEDGE Addition of axUS assessment to wire localisation of CN reduces its FNR for detecting residual metastasis after NACT.
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Affiliation(s)
- Vishnu Prasad Pulappadi
- Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, India
| | - Shashi Paul
- Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, India
| | - Smriti Hari
- Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, India
| | - Ekta Dhamija
- Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, India
| | - Smita Manchanda
- Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, India
| | - Kamal Kataria
- Department of Surgical Disciplines, All India Institute of Medical Sciences, New Delhi, India
| | - Sandeep Mathur
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Kalaivani Mani
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Ajay Gogia
- Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India
| | - Svs Deo
- Department of Surgical Oncology, All India Institute of Medical Sciences, New Delhi, India
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Arora S, Gogia DA, Deo S, Sharma D, Mathur SR. Neoadjuvant pertuzumab plus trastuzumab in combination with anthracycline- free chemotherapy regimen in patients with HER2 positive breast cancer-Real-world data from a single center in India. Cancer Treat Res Commun 2021; 29:100483. [PMID: 34710849 DOI: 10.1016/j.ctarc.2021.100483] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 10/18/2021] [Accepted: 10/19/2021] [Indexed: 01/23/2023]
Abstract
BACKGROUND Dual targeted therapy with chemotherapy is one of the therapeutic approaches as neoadjuvant treatment in HER2/neu positive breast cancer (BC). However, the safety and efficacy data of dual-targeted, chemotherapy regimen (docetaxel, carboplatin, trastuzumab, & pertuzumab [TCH-P] is limited from the Indian subcontinent. METHODS This retrospective study aims to evaluate the efficacy and toxicity of neoadjuvant TCH-P regimen in early, locally advanced, and oligometastatic (OM) HER2-positive BC, at All India Institute of Medical Sciences, New Delhi, India, in between the period 2015-2020. Total 6 cycles of 3-weekly neoadjuvant chemotherapy (NACT) protocol containing docetaxel (75 mg/m2), carboplatin (AUC = 6), trastuzumab (8 mg/kg loading followed by 6 mg/kg) and pertuzumab (840 mg loading followed by 420 mg) were planned. Subcutaneous peg-filgrastim was prophylactically administered on day 2 of each cycle. The primary outcome was the pathological complete response (pCR), and secondary outcomes were clinical overall response rate (ORR), rate of breast conservation surgery (BCS) for patients for whom modified radical mastectomy (MRM) was planned and toxicity. RESULTS Forty-five patients with a median age of 48 years (31-65) were included in this study. The TNM (AJCC-7th edition) stage distribution was stage II, 14 (31.1%); stage III, 29 (64.5%); and stage IV (OM), 2 (4.4%). Clinical node positivity disease was found in 26 (57.8%) cases. Nineteen (42.2%) patients had hormone-positive and 26 (57.8%) cases were premenopausal. The clinical ORR and CR were seen in 100% and 60% respectively. Overall pCR rate was observed in 25 (55.6%) patients (70% in stage II). BCS was performed in 23 (51.1%) cases. In 12 (26.6%) cases, planned MRM was changed to BCS following NACT. Grade 3 and 4 toxicities were diarrhea 7 cases, thrombocytopenia in 6, neutropenia in 4, febrile neutropenia in 1, and anaemia in 2 cases. Ten patients required dose modification. No patient had congestive heart failure or induction death. CONCLUSIONS This is the first study of the non-anthracycline-based neoadjuvant protocol in HER2 positive BC from India. The TCH-P is an effective, safe, and well tolerated protocol with a pCR rate of 55.6% and 26.6% BCS conversion rate from planned MRM.
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Affiliation(s)
- Shalabh Arora
- DR BRA-IRCH, Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India
| | - Dr Ajay Gogia
- DR BRA-IRCH, Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India.
| | - Svs Deo
- DR BRA-IRCH, Department of Surgical Oncology, All India Institute of Medical Sciences, New Delhi, India
| | - Dayanand Sharma
- DR BRA-IRCH, Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India
| | - Sandeep R Mathur
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
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Saikia J, Malik P, Kumar S, Jain D, Madan K, Bharati S, Deo S, Kumar S. 7P Predictive and prognostic value of cell-free DNA in plasma and pleural lavage among surgically treated adenocarcinomas of the lung (ADCL). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.2003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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17
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Sharma A, Sharma A, Sharma V, Kumar S, Kumar A, Deo S, Pathy S, Shukla NK, Pramanik R, Raina V, Thulkar S, Kumar R, Mohanti BK. Long-Term Survivors of Metastatic Colorectal Cancer: A Tertiary Care Centre Experience. South Asian J Cancer 2021; 10:87-91. [PMID: 34568221 PMCID: PMC8460352 DOI: 10.1055/s-0041-1736343] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Background
Prognosis of metastatic colorectal cancer (mCRC) is poor and goal of treatment is mainly palliative unless there is limited metastatic disease which is surgically resectable. Here, we report a case series of long-term survivors treated predominantly with chemotherapy.
Methods
This is a single-center retrospective analysis of patients of mCRC. Records of metastatic colorectal cancer patients registered at Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, between the year 2005 and 2015 were retrieved and reviewed. Inclusion criteria were patients who survived 5 years or more, treated mainly by chemotherapy, with either initial presentation as metastatic disease or those who progressed after initial surgery with or without adjuvant therapy. The details about the patient characteristics, treatment, and outcome were collected. The data were censored on September 30, 2020.
Results
Records of 370 mCRC patients were reviewed. Thirty-one patients with all the available details fulfilled the criteria for inclusion in the study. Median age was 53 years (range, 22–74 years). Sixteen were women (51.6%). Twenty-four (77%) were newly diagnosed cases with initial presentation as metastatic disease. Commonest site of primary was on the left (21, 67.6%) followed by right side and transverse colon in 5 patients each. Liver was the most common site of metastasis (
n
= 18, 58.06%). In metastatic setting, the most common chemotherapy regimen used in the first line was CAPOX (
n
= 11, 35.48%). Only three patients could undergo metastatectomy. Monoclonal antibodies could be used only in 14 patients. Median overall survival (OS) of this cohort is 81.6 months (95% confidence interval [CI], 69.73–117.9).
Conclusion
A small but significant proportion of mCRC patients may achieve and maintain durable responses and long term survival with use of combination of chemotherapy with or without biologics.
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Affiliation(s)
- Aparna Sharma
- Department of Medical Oncology, Dr. B. R. Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Atul Sharma
- Department of Medical Oncology, Dr. B. R. Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Vinod Sharma
- Department of Medical Oncology, Dr. B. R. Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Sunil Kumar
- Department of Surgical Oncology, Dr. B. R. Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Akash Kumar
- Department of Medical Oncology, Dr. B. R. Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Svs Deo
- Department of Surgical Oncology, Dr. B. R. Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Sushmita Pathy
- Department of Radiation Oncology, Dr. B. R. Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - N K Shukla
- Department of Surgical Oncology, Dr. B. R. Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Raja Pramanik
- Department of Medical Oncology, Dr. B. R. Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Vinod Raina
- Department of Medical Oncology, Dr. B. R. Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Sanjay Thulkar
- Department of Radiodiagnosis, Dr. B. R. Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Rakesh Kumar
- Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - B K Mohanti
- Department of Radiation Oncology, Dr. B. R. Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
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Bhoriwal SK, Kumar S, Deo S, Sharma J, Mishra A, Kumar N, Saikia J, Dhall K. Clinical outcomes and technical description of unstented end to side pancreaticogastrostomy by small posterior gastrotomy. Ann Hepatobiliary Pancreat Surg 2021; 25:251-258. [PMID: 34053928 PMCID: PMC8180407 DOI: 10.14701/ahbps.2021.25.2.251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 11/12/2020] [Accepted: 11/13/2020] [Indexed: 12/09/2022] Open
Abstract
Backgrounds/Aims Morbidity following Whipple’s surgery largely depends upon the pancreatic stump anastomosis leak. Pancreaticogastrostomy is one of the techniques of pancreatic stump reconstruction and is described variously in the literature. Duct to mucosa pancreaticogastrostomy is described either by a large 3-4 cm posterior gastrotomy or by small gastrotomy of 2-3 mm with the use of internal stents along with. We describe clinical outcomes and technique of 2 layer end to side pancreatico-gastrostomy by a small posterior gastrotomy without the use of internal stents. Methods Hospital records of 35 patients where the technique of, small posterior gastrotomy end to side duct to mucosa pancreatico-gastrostomy without internal stents, was used for pancreatic stump reconstruction were studied retrospectively. The data were analyzed for demographic details, stage of the disease, and short term outcomes related to surgical procedure. Results The mean duration of surgery was 7.4 hours. Grade A, B, and C POPF were observed in 10 (28.5%), 3 (8.5%), and 1 (2.8%) of patients respectively. The mean time to remove pancreatic drain was 9 days, and the mean time to start oral feeds was 8.9 days. The mean hospital stay was 12.9 days (07-26). Thirty days mortality was 2.8%. Conclusions Unstented duct to mucosa end to side pancreatico-gastrostomy technique is comparable with other pancreatico-gastrostomy techniques in outcomes in terms of POPF, morbidity, mortality, and hospital stay. However, to establish the superiority or inferiority of this technique, a larger study is recommended.
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Affiliation(s)
- Sandeep Kumar Bhoriwal
- Department of Surgical Oncology, All India Institute of Medical Science, New Delhi, India
| | - Sunil Kumar
- Department of Surgical Oncology, All India Institute of Medical Science, New Delhi, India
| | - Svs Deo
- Department of Surgical Oncology, All India Institute of Medical Science, New Delhi, India
| | - Jyoti Sharma
- Department of Surgical Oncology, All India Institute of Medical Science, New Delhi, India
| | - Ashutosh Mishra
- Department of Surgical Oncology, All India Institute of Medical Science, New Delhi, India
| | - Naveen Kumar
- Department of Surgical Oncology, All India Institute of Medical Science, New Delhi, India
| | - Jyoutishman Saikia
- Department of Surgical Oncology, All India Institute of Medical Science, New Delhi, India
| | - Kunal Dhall
- Department of Surgical Oncology, All India Institute of Medical Science, New Delhi, India
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Mittal A, Pramanik R, Gogia A, Batra A, Jha A, Kumar L, Deo S, Bhoriwal S, Deb K, Dhamija E, Ramprasad V, Olopade O. 155P Profile of pathogenic mutations and evaluation of germline genetic testing criteria in consecutive breast cancer patients treated at a North Indian tertiary care center. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.03.169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Saikia J, Bansal B, Deo S, Kumar N, Kuppusamy R, Barua A, Ray MD. Hyperthermic intraperitoneal chemotherapy in locally advanced and recurrent ovarian carcinoma: surgical and oncological outcomes in the Indian public healthcare system. Future Oncol 2021; 17:1761-1776. [PMID: 33728945 DOI: 10.2217/fon-2020-0806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
This study analyzed the surgical outcomes after initial implementation of a cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) program in government settings in India. Methods: Ovarian cancer patients undergoing cytoreductive surgery and HIPEC from May 2015 to April 2019 were identified from a prospectively maintained database. Treatment characteristics and surgical outcomes were analyzed. Results: The study identified 101 patients. The mean peritoneal cancer index (PCI) was 7 ± 6, with higher PCI scores in primary and recurrent cases. Major morbidities were recorded in 24.7% of patients. High PCI score, completeness of cytoreduction and major morbidities were independent predictors of overall survival in multivariate analysis. Conclusion: The application of HIPEC in limited-resource settings is feasible with acceptable major morbidities. This program should receive similar priority in government systems.
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Affiliation(s)
- Jyoutishman Saikia
- Department of Surgical Oncology, DR. BRAIRCH, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Babul Bansal
- Department of Surgical Oncology, DR. BRAIRCH, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Svs Deo
- Department of Surgical Oncology, DR. BRAIRCH, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Navin Kumar
- Department of Surgical Oncology, DR. BRAIRCH, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Raghuram Kuppusamy
- Department of Surgical Oncology, DR. BRAIRCH, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Areendam Barua
- Department of Surgical Oncology, DR. BRAIRCH, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - M D Ray
- Department of Surgical Oncology, DR. BRAIRCH, All India Institute of Medical Sciences, New Delhi, 110029, India
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Sharma A, Mohanti B, Thakar A, Bhasker S, Sikka K, Singh A, Pramanik R, Kumar R, Biswas A, Deo S, Thulkar S, Bahadur S. 959P Analysis of concurrent chemo-radiation using weekly cisplatin in locally advanced SCCHN: Identification of prognostic factors. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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22
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K R, Kumar S, Bhoriwal S, Deo S, Sharma A, R. Kumar. P-174 When to do PET-CT and diagnostic laparoscopy in gall bladder cancer? A prospective study to assess the role of PET-CT and diagnostic laparoscopy in the staging of gall bladder cancer. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.04.256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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K R, Deo S, Kumar S, Bhoriwal S, Sharma A, Pathy S. P-287 Does endemic gallbladder cancer behave differently? Data of clinical spectrum, management and outcome of gallbladder cancer patients from a north Indian tertiary cancer centre. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.04.369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Affiliation(s)
- Navin Kumar
- Department of Surgical Oncology, All India Institute of Medical Sciences, New Delhi, India
| | - Svs Deo
- Department of Surgical Oncology, All India Institute of Medical Sciences, New Delhi, India
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Abstract
e12567 Background: This study was undertaken to evaluate the clinic-pathological characteristics and outcome of patients with female breast cancer at I.R.C.H, AIIMS, New Delhi, one of the largest tertiary-care cancer center in India. Methods: This ambispective study included patients with breast cancer in females, registered at our institute from January 1st, 2014 to December 31st, 2018.We retrieved data from prospectively maintained clinical case records. Results: We included 997 patients with median age of 47.5 years (21–90) The TNM (AJCC-7th edition) stage distribution was stage I, 40 (4.01%); stage II, 326 (32.70%); stage III, 419 (42.02%); and stage IV, 212 (21.26%). The median tumour diameter was 5 cm. Infiltrating ductal carcinoma (96%) was the most common histologic subtype. Fifty eight percent of cases were positive for ER or/ and PR whereas 30.89% patients were HER2/neu positive. Triple negativity was found in 29.88 % of cases. Patients underwent breast conserving surgery in 28.2% of cases, 41.7% were received neo-adjuvant chemotherapy and 9.5 % of patients offered palliative chemotherapy. The pathological complete response was seen in 20.5% of cases. Loco-regional recurrence occurred in 2.8%, and 23.2% of patients developed distant metastases. The discordance of receptor was present in 20.5% for ER, 25.1% for PR, and 15 % for HER2/neu on re-biopsy at the time of relapse . Only 37.83% of the eligible patients received trastuzumab upfront. For non- metastatic group, the median time of relapse was 36 months, 3 year relapse free survival (RFS) was 73.5% and overall survival (OS) was 82.1% . Clinical stage(stage III), triple negativity and HER2 neu positivity were associated inferior RFS however pathological node involvement (HR 1.4, 95% CI 1.01–2.18, p = 0.01) and triple negativity (HR 1.9, 95% CI 1.36–2.90, p = 0.001) were associated with poor OS . For metastatic group, the median time of progression was 18 months and 3 year progression free survival (PFS) was 35% and OS was 20%. More than 2 sites of metastasis, upfront brain metastasis, triple negativity, and poor performance status (ECOG III/IV) were associated with inferior survival. Conclusions: This is one of the largest comprehensive data from a single center. Majority of our patients are younger in age, advance in stage, aggressive in biology and unaffordability of targeted therapy on eligible patients might lead to poor overall outcome. Triple negativity is found in around 30% of cases and associated with poor survival.
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Affiliation(s)
- Ajay Gogia
- All India Institute of Medical Sciences, Delhi, India
| | - Svs Deo
- All India Institute of Medical Science (AIIMS), New Delhi, India
| | - Dayanand Sharma
- Department of Radiation Oncology, Dr BRA Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Sandeep Mathur
- All India Institute of Medical Sciences, New Delhi, India
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Choudhary P, Gogia A, Deo S, Mathur S, Sharma D. Neoadjuvant chemotherapy in locally advanced breast cancer: Clinicopathological characteristics and correlation with pathological complete response. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.e12658] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e12658 Background: The data regarding incidence, response rates to neoadjuvant chemotherapy (NACT) and factors affecting pathological complete response (pCR) rate in locally advanced breast cancer (LABC) patients are lacking from India. Methods: This ambispective study was carried out at B.R.A., I.R.C.H, AIIMS, New Delhi, in between period of January 2013 to December 2019. We screened 1500 cases of breast cancer who presented to our institute and found 600 cases to be LABC,425 patients were started on NACT, 284 had undergone surgery and were included in our analysis. Results: The median age of diagnosis was 46 years (range 24-72years). Fifty four percent cases were postmenopausal, 54% had a left sided cancer,45 % right sided cancer,1 % had bilateral breast cancer. The median duration of symptoms was 5 months. The clinical stage according to AJCC staging system was Stage IIB – 11%(32), IIIA -21 % (58), IIIB- 60%(169) and IIIC- 8%(24) .Sixty five percent(186) cases presented with clinical skin involvement and 80% (228) patients has clinical node positivity.In our cohort 52% (148) cases were hormone positive (ER/PR positive), 42 %(119) cases were HER2/neu positive, 30%(84) were triple negative breast cancer (TNBC), 23 % (67) were positive for ER/PR and HER2/neu. Ninety percent of the cases were able to receive the planned neoadjuvant treatment before surgery. Post NACT 83% cases had a modified radical mastectomy (MRM) and 17% were able to undergo breast conserving surgery (BCS).Overall pCR was achieved in 59(21%) cases, 17% in hormone positive cases, 25% in HER2/neu positive cases (30% in cases receiving HER2/neu directed therapy vs 20% in cases who didn’t receive HER2 /neu directed therapy) and 27% in TNBC cases. During the study period 54 cases (19%) had relapsed,8 cases (3%) had a local relapse and a 46 cases (16%) had a systemic relapse. Grade ¾ toxicity occurred in 25 % cases, the most common were diarrhea, neutropenia, CINV, oral mucositis and thrombocytopenia and other rare toxicities (DVT, hand foot syndrome,myalgia). Febrile neutropenia was recorded in 2.5 % cases. There were 2 induction deaths. Stage II, absence of ER/PR expression showed statistically significant correlation with path CR rates. Conclusions: Locally advanced breast cancer constitutes around 40% cases at our institute. Post NACT pCR was achieved in 21% of cases, HER2/neu positive cases and TNBC showed higher pCR rates. The factors affecting pCR rate were absence of ER/PR expression and stage II disease.
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Affiliation(s)
| | - Ajay Gogia
- All India Institute of Medical Sciences, Delhi, India
| | - Svs Deo
- All India Institute of Medical Science (AIIMS), New Delhi, India
| | - Sandeep Mathur
- All India Institute of Medical Sciences, New Delhi, India
| | - Dayanand Sharma
- Department of Radiation Oncology, Dr BRA Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
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Sharma A, Chaudhary M, Thakar A, Bhaskar S, Sikka K, Pramanik R, Biswas A, Singh C, Sahoo R, Deo S, Kumar R, Thulkar S, Kakkar A, Seth S, Sreenivas V. Concurrent chemotherapy and external radiation therapy: An open label non-inferiority phase III randomized controlled trial of weekly versus three weekly cisplatin and radical radiotherapy in locally advanced head and neck squamous cell carcinoma: CONCERT trial. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz252.064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Charlier P, Deo S. 19th c. tuberculosis probably has nothing to do with current tuberculosis. J Neurol Sci 2019; 402:107. [DOI: 10.1016/j.jns.2019.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 05/14/2019] [Indexed: 10/26/2022]
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Rastogi S, Aggarwal A, Dhamija E, Barwad A, Panday R, Khan SA, Sampat kumar V, Shishak S, Kumar C S, Deo S, Manasa P, Kapoor R, Kumar P. Desmoid tumor (DT) management in dedicated sarcoma medical oncology clinic in a developing country: Lessons learnt. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.e22541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e22541 Background: There is lack of data about desmoid tumors from India except case reports. It is not known how these patients are dealt with outside tertiary care centres who lack expertise. Methods: We retrospectively analysed all patients of DT from a prospectively maintained database who were referred to AIIMS Sarcoma Medical Oncology Clinic from January 2016 till 2019. Results: There were total of 56 patients with male: female ratio of 3:4. Median age was 26 (3-57) years. Extremity was most common site (57%) and median tumour size was 12 (range 3-20) cm. One patient (1.8%) had FAP and 1 (1.8%) had multifocal disease. A total of 27 patients received first treatment outside our institute and was primary surgery in all (100%). However, of the remaining 29 patients who primarily presented to us, surgery was done only in 3 (10%) because of patients choice and pelvic location. Five patients were kept under observation and all are doing well. Tamoxifen with celecoxib was most common first line therapy in 80% (40/50) with other options being sorafenib (6/50) and chemotherapy (4/50). Chemotherapy was used in abdomen (3/4) and head neck (1/4) primary patients. Menstrual irregularities including amenorrhoea was most common toxicity in 33% (13/40) with tamoxifen combination and a cause of concern in this cohort of young females leading to discontinuation of therapy inspite of SD in 54% (7/13) patients. Second line therapy was started in 20 patients with sorafenib being most common (13/20), others being chemotherapy (4/20), tamoxifen combination (2/20) and imatinib (1/20). Of all 19 patients on sorafenib, 10 (53%) experienced Hand Foot Syndrome. None discontinued sorafenib due to HFS. After median follow up of 15 months, median progression free survival (PFS) with first line was 29 months (11-46) and with second line it was not reached. There have been three deaths till date (5.3%), all were non-extremity primaries. Conclusions: In Indian setup, majority of patients presenting outside tertiary care centre undergo surgery as the first line therapy without any inclusion of medical therapy. This might be attributed to lack of awareness about medical therapy and natural trajectory of disease. Tamoxifen though was a commonly used option, led to toxicity which is of concern in young Indian patients leading to discontinuation. Sorafenib is well tolerable except HFS but longer follow up is needed for efficacy analysis.
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Affiliation(s)
- Sameer Rastogi
- All India Institute of Medical Sciences, Ghaziabad, India
| | - Aditi Aggarwal
- National Cancer Institute, All India Institute Of Medical Sciences,Jhajjar, Haryana, Delhi, India
| | - Ekta Dhamija
- All India Institute of Medical Science (AIIMS), New Delhi, India
| | | | | | | | | | - Sorun Shishak
- All India Institute Of Medical Sciences, New Delhi, India
| | | | - Svs Deo
- All India Institute of Medical Science (AIIMS), New Delhi, India
| | - Parisa Manasa
- All India Institutes of Medical Sciences, New Delhi, India
| | | | - Pankaj Kumar
- Dr. B. R. Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
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Shishak S, Rastogi S, Panday R, Sharma D, Barwad A, Aggarwal A, Dhamija E, Gupta A, Balan S, Deo S, Dutta R, Manasa P, Kumar C S, Kumar P. Renal Ewing's sarcoma: A single institute experience of seven patients. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.e22538] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e22538 Background: Renal Ewing’s sarcoma constitutes a rare subset of extraskeletal ewings with aggressive clinical course and dismal outcomes. The purpose of our study was to review our experience in the management of patients with Renal Ewing’s Sarcoma. Methods: We retrospectively analysed patients with Renal Ewing’s Sarcoma who were registered in Sarcoma Medical Oncology Clinic at AIIMS, New Delhi between September 2016 and January 2019. Results: A total of eight patients were registered in the study period, one of which was diagnosed with wilms tumor post nephrectomy and was excluded from our study. Of seven patients included in analysis, five (71.4%) were males. The commonest symptoms were flank pain (57.1%) and hematuria (57.1%). The median age was 28 years (range, 18 to 50 years). The mean Hemoglobin was 10.4 g/dl (range, 6-14 g/dl). The median tumor size was 13 cm (range, 5-25 cm). Four patients (57.1%) were non-metastatic while three (42.9%) had metastases in bone, lung and liver, and peritoneum respectively. Diagnosis was established by an upfront nephrectomy in four patients (57.1%) and biopsy in three patients (42.9%). Translocation for EWSR1 was done in 5 patients of which four (80%) were positive and one patient (20%) were negative. The test was not carried out in two patients due to inadequate tissue sampling. Three patients received neoadjuvant chemotherapy with VAC and the rest (four) received it after surgery. Ifosfamide-etoposide (IE) was added to VAC regimen in first two patients, in one being added post nephrectomy. This patient developed Ifosfamide-induced renal failure resulting in death. Radiotherapy was given in two patients, one pre-operative owing to large inoperable mass, and post operative in the other due to positive margins. At last follow up, three patients (42.9%) are alive and are on chemotherapy after radical nephrectomy. Four patients (57.1%) have died, three due to disease (all metastatic) and one due to chemotoxicity. The median survival was 15 months. Conclusions: Unlike extremity, renal ewings sarcoma more commonly presents in higher age and with advanced disease. Translocation studies are a prerequisite in a suspected case of Renal Ewings Sarcoma, especially due to possibility of discrepancies in pre and post-operative diagnoses. Our institutional protocol does not recommend the use of Ifosfamide in the subset of patients with single kidney, post nephrectomy. Caution must be exercised before instituting the drug and should be given only pre-operatively in absence of renal dysfunction.
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Affiliation(s)
- Sorun Shishak
- All India Institute Of Medical Sciences, New Delhi, India
| | - Sameer Rastogi
- All India Institute of Medical Sciences, Ghaziabad, India
| | | | - Dayanand Sharma
- Department of Radiation Oncology, Dr BRA Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | | | - Aditi Aggarwal
- National Cancer Institute, All India Institute Of Medical Sciences,Jhajjar, Haryana, Delhi, India
| | - Ekta Dhamija
- All India Institute of Medical Science (AIIMS), New Delhi, India
| | - Anshul Gupta
- All India Institute of Medical Sciences, New Delhi, India
| | - Soorej Balan
- All India Institute Of Medical Sciences, Delhi, India
| | - Svs Deo
- All India Institute of Medical Science (AIIMS), New Delhi, India
| | - Rimlee Dutta
- All India Institutes of Medical Sciences, New Delhi, India
| | - Parisa Manasa
- All India Institutes of Medical Sciences, New Delhi, India
| | | | - Pankaj Kumar
- Dr. B. R. Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
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Jha D, Deo S, Malhotra M. Radioguided occult lesion localization and sentinel node and occult lesion localization in breast cancer: The future beckons. Asian Journal of Oncology 2019. [DOI: 10.4103/2454-6798.173283] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
ABSTRACTWire Guided Localisation has been the traditional technique for occult breast lesions. However, ROLL has emerged as a safer alternative to WGL approach. ROLL provides an improvement on margin positive rates and offers better pain and cosmetic advantages to the patient combined with a shorter learning curves for both radiologists and surgeons. SNOLL adds to the advantages of the procedure by combining SLNB with ROLL hence offering an economic advantage. The use of ROLL as primary modality for occult lesion localisation is bound to increase with potential to replace WGL as the primary modality for such lesions.
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Affiliation(s)
- Deepak Jha
- Department of Surgical Oncology, Artemis Hospital, Gurgaon, Delhi NCR, India
| | - S. Deo
- Department of Surgical Oncology, Dr. BRA-IRCH, AIIMS, New Delhi, India
| | - Mandeep Malhotra
- Department of Surgical Oncology, Artemis Hospital, Gurgaon, Delhi NCR, India
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Singh R, Bhoriwal S, Gogia A, Sharma D, Deo S. Routine cavity shave during breast conservation surgery is a good alternative to frozen sections. Breast 2019. [DOI: 10.1016/s0960-9776(19)30375-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Gogia A, Raina V, Deo S, Sharma D, Mathur S. Survival outcome of pregnancy associated breast cancer in resource limited country: an analysis. Breast 2019. [DOI: 10.1016/s0960-9776(19)30244-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Singh R, Bhoriwal S, Deo S, Kumar R. Comparison of Pet-CT versus conventional staging investigations for locally advanced breast cancer (LABC): results of a prospective study. Breast 2019. [DOI: 10.1016/s0960-9776(19)30231-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Singh R, Kumar S, Gogia A, Sharma D, Deo S. Impact of tumor size on prediction of pathological complete response after neoadjuvant chemotherapy in breast cancer. Breast 2019. [DOI: 10.1016/s0960-9776(19)30264-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Gogia A, Deo S, Mathur S, Sharma D, Gupta R. Predictive significance of derived Neutrophil to lymphocyte ratio with neo-adjuvant chemotherapy in triple negative breast cancer: a single center analysis. Breast 2019. [DOI: 10.1016/s0960-9776(19)30133-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Gogia A, Raina V, Deo S, Shukla N, Mohanti B, Sharma D, Mathur S. Neoadjuvant chemotherapy for young (</ = 35 years) locally advanced breast cancer patients: association of pathological complete response with survival. An Institutional analysis from developing country. Breast 2019. [DOI: 10.1016/s0960-9776(19)30426-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Patel A, Deo S, Bhatnagar S. A Survey of Medical Professionals in an Apex Tertiary Care Hospital to Assess Awareness, Interest, Practices, and Knowledge in Palliative Care: A Descriptive Cross-sectional Study. Indian J Palliat Care 2019; 25:172-180. [PMID: 31114100 PMCID: PMC6504741 DOI: 10.4103/ijpc.ijpc_191_18] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background: Medical discipline in India focuses on cure rather than comfort care. Palliative care is concerned with improving quality of life and relieving sufferings in patients with advanced incurable terminal diseases. Palliative care in India is still in infancy stage due to lack of knowledge, attitude and skills among health care providers. The reason being lack of training in under graduate as well as postgraduate teaching curriculum and lack of sensitization among policy makers. Aims and Objectives: To assess the awareness, interest, practices and knowledge in palliative care among medical professionals working in a tertiary care hospital. Materials and Methods: All participants were mailed proforma to be filled in a fixed format including details of their qualification, demographic data, their field of work, their training in palliative care and multiple choice questions regarding awareness interest, practices and knowledge of palliative care. Results: Out of 186 respondents, 56% had not received any basic training in palliative care. 81% wanted palliative care education to be included in undergraduate curriculum. Poor program was identified as the most common barrier in learning palliative care. 77% respondents had no idea about home based palliative care services. 50.8% patients dies in hospital in their terminal stage. 88% were interested in learning safe opioid practices. Although 89.8% were aware of the need of palliative care in metastatic cancer but less than 50% were aware of the fact that palliative care is also required in MDR-TB and mental illness. Conclusion: This study reflects data of an apex cancer institute of the country. The result of awareness is not very encouraging despite a dedicated palliative care department. So, we can assume what will be the palliative care status in other parts of India where there is no palliative care at all. Recommendation: We strongly recommends that palliative care teaching should be incorporated in undergraduate curriculum to sensitize the students from the beginning. Budding residents in their learning phase can play an important role by learning and providing palliative care as the first person to come into contact with the patients are residents. There is a strong need of spreading palliative care awareness all over the country.
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Affiliation(s)
- Anuradha Patel
- Department of Onco-Anaesthesia and Palliative Medicine, Dr. BRA Institute Rotary Cancer Hospital, AIIMS, New Delhi, India
| | - Svs Deo
- Department of Surgical Oncology, Dr. BRA Institute Rotary Cancer Hospital, AIIMS, New Delhi, India
| | - Sushma Bhatnagar
- Department of Onco-Anaesthesia and Palliative Medicine, Dr. BRA Institute Rotary Cancer Hospital, AIIMS, New Delhi, India
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Charlier P, Deo S. Schizophrenia: four examples of historical retrospective diagnosis. Encephale 2018; 44:S55-S57. [PMID: 30935490 DOI: 10.1016/s0013-7006(19)30082-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
It is difficult to know precisely the history of a functional disease, unlike the natural history of infectious agents, tumour processes or poly-malformative syndromes. In the case of psychiatry, and especially schizophrenia and psychotic disorders, a retrospective look at artistic productions (writings and drawings) makes it possible to reconstitute a whole section of this pathological context. Through four medieval and modern examples, we will see how it is possible to do a paleo-psychiatry: Opicinus de Canistris (14th c.), the Voynich manuscript (15th c.), Hieronymus Bosch (15th-16th c.), and the Codex Seraphinianus (20th c.).
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Affiliation(s)
- P Charlier
- Section of Medical Anthropology (UVSQ, EA4498, Dante Laboratory), UFR of Health Sciences, 2, avenue de la Source-de-la-Bièvre, 78180 Montigny-Le-Bretonneux, France; CASH & IPES, 403, avenue de la République, 92000 Nanterre, France.
| | - S Deo
- Section of Medical Anthropology (UVSQ, EA4498, Dante Laboratory), UFR of Health Sciences, 2, avenue de la Source-de-la-Bièvre, 78180 Montigny-Le-Bretonneux, France
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Bansal B, Gowda M, Kumar V, Deo S, Bhoriwal S, Jain D, Malik P, Jee Bharati S, Yadav M, Kumar S. Rate of pathological N2 nodes among patients of NSCLC with cN0/cN1 nodal status on CECT scan: A study from tertiary care hospital in India. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy445.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Gowda M, Bansal B, Kumar V, Deo S, Bhoriwal S, Jain D, Malik P, Jee Bharati S, Kumar S. P3.09-22 Correlation Between Maximum Tumour Diameter Measurement on CT-Scan and Histopathological Specimen: An Indian Experience. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Kumar N, Deo S, Shukla N, Bhoriwal S, Sharma A, Pramanik R, Sahoo R, Kumar S. Neoadjuvant chemotherapy for locally advanced squamous cell carcinoma of esophagus: Clinical profile and outcomes from tertiary care cancer centre. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy151.047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Kumar N, Deo S, Shukla N, Boriwal S, Kumar V, Ramanathan P, Jain D, Madan K, Kumar S. 225P Surgical experience of advanced bronchopulmonary carcinoids: An analysis from a tertiary care hospital of North India. J Thorac Oncol 2018. [DOI: 10.1016/s1556-0864(18)30497-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Perciaccante A, Charlier P, Coralli A, Deo S. Pope Francis and the end-of-life: Time for serious reflection. Eur J Intern Med 2018; 48:e33-e34. [PMID: 29208454 DOI: 10.1016/j.ejim.2017.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Accepted: 11/30/2017] [Indexed: 11/24/2022]
Affiliation(s)
- A Perciaccante
- Department of Medicine, "San Giovanni di Dio" Hospital, via Fatebenefratelli 34, 34170 Gorizia, Italy.
| | - P Charlier
- Section of Medical Anthropology (UVSQ, DANTE Laboratory EA 4498), 2 avenue de la Source de la Bièvre, 78180 Montigny-Le-Bretonneux, France; CASH & IPES, 403 avenue de la République, 92000 Nanterre, France
| | - A Coralli
- Azienda per l'Assistenza Sanitaria Bassa Friulana-Isontina, Servizio Infernieristico, Italy
| | - S Deo
- Section of Medical Anthropology (UVSQ, DANTE Laboratory EA 4498), 2 avenue de la Source de la Bièvre, 78180 Montigny-Le-Bretonneux, France
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Tiwari A, Gogia A, Deo S, Shukla NK, Mathur S, Sharma DN. Retrospective study of efficacy and safety of neoadjuvant docetaxel, carboplatin, and trastuzumab in HER2-positive locally advanced and oligometastatic breast cancer: An Indian experience. Indian J Cancer 2017; 54:343-346. [PMID: 29199719 DOI: 10.4103/ijc.ijc_152_17] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND The neoadjuvant chemotherapy in HER2-positive breast cancer consists of a chemotherapy backbone and HER2-directed therapy. The increase in cardiotoxicity by the use of trastuzumab with an anthracycline-based regimen has led to the use of nonanthracycline-based alternative regimens. The docetaxel, carboplatin, and trastuzumab (TCH) are one such regimen. The efficacy and toxicity of this regimen have not been widely studied in Indian patients. AIMS This retrospective study aims to evaluate the efficacy and toxicity of neoadjuvant TCH regimen in locally advanced and oligometastatic HER2-positive breast cancer in Indian patients. METHODOLOGY The hospital records between January 2014 and December 2016 were reviewed to identify patients with locally advanced and oligometastatic HER2-positive breast cancer treated with uniform 3-weekly neoadjuvant chemotherapy protocol-containing docetaxel (75 mg/m2), carboplatin (AUC = 6), and trastuzumab (8 mg/kg loading followed by 6 mg/kg) (TCH). The primary outcome was the pathologic complete response (pCR), which was defined as an absence of invasive and noninvasive cancer in breast or lymphnode. RESULTS Thirty-two patients with mean age 46 years met our inclusion criteria, of these 24 patients had locally advanced breast cancer, and eight patients had oligometastatic breast cancer. 13 (40.6%) patients had hormone-positive breast cancer. The objective response rate as assessed clinically was 100%, and pCR rate was 36.3%. The patients with oligometastatic breast cancer also showed a good response to chemotherapy with three patients showing pCR and four patients showing resolution disease at metastatic sites. The patients experienced very few Grade III/IV toxicities, and no patient had clinical congestive heart failure. CONCLUSION The TCH protocol is an efficacious neoadjuvant chemotherapy regimen for locally advanced and oligometastatic breast cancer and is safe and well tolerated in this population.
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Affiliation(s)
- A Tiwari
- Department of Medical Oncology, Dr. B. R. A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - A Gogia
- Department of Medical Oncology, Dr. B. R. A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Svs Deo
- Department of Surgical Oncology, Dr. B. R. A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - N K Shukla
- Department of Surgical Oncology, Dr. B. R. A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - S Mathur
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - D N Sharma
- Department of Radiotherapy, Dr. B. R. A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
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Perciaccante A, Deo S, Coralli A, Charlier P, Appenzeller O, Bianucci R. Did Liszt have chronic pulmonary thromboembolism? The Lancet Respiratory Medicine 2017; 5:931-932. [DOI: 10.1016/s2213-2600(17)30354-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Perciaccante A, Coralli A, Deo S, Appenzeller O. Antonio Ligabue: "the Madman". Med Hypotheses 2017; 109:174-175. [PMID: 29150281 DOI: 10.1016/j.mehy.2017.10.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 10/06/2017] [Accepted: 10/15/2017] [Indexed: 11/18/2022]
Affiliation(s)
- A Perciaccante
- "San Giovanni di Dio" Hospital, Department of Medicine, via Fatebenefratelli, 34, 34170 Gorizia, Italy.
| | - A Coralli
- Distretto Alto Isontino, Azienda per l'Assistenza Sanitaria n. 2 Bassa Friulana - Isontina, Viale Venezia Giulia, 74, 34071 Cormons, Gorizia, Italy
| | - S Deo
- Section of Medical and Forensic Anthropology (UVSQ & Paris-Descartes University EA 4569), Montigny-Le-Bretonneux, France; CASH & IPES, avenue de la République, 403, 92014 Nanterre, France
| | - O Appenzeller
- New Mexico Health Enhancement and Marathon Clinics Research Foundation, 361 Big Horn Ridge Dr. NE, Albuquerque, NM, USA; New Mexico Museum of Natural History and Science, 1801 Mountain Road NW, Albuquerque, NM, USA
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Charlier P, Bou Abdallah F, Mostefai Dulac Y, Deo S, Jacqueline S, Brun L, Hervé C. ["Palimpsest scar" lesions in a context of torture (Darfur, Sudan)]. Ann Dermatol Venereol 2017; 144:696-699. [PMID: 28728860 DOI: 10.1016/j.annder.2017.06.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 02/16/2017] [Accepted: 06/12/2017] [Indexed: 11/15/2022]
Abstract
BACKGROUND As a result of the current exponentially growing refugee population from the Middle-East and East Africa (Sudan, Darfur, Eritrea), clinicians (including forensic pathologists) are seeing atypical skin lesions, mainly of a traumatic nature, but in some cases associated with long-standing lesions related to ethnic practices. PATIENTS AND METHODS A case of torture sequelae is presented herein in a patient originally from Darfur (Sudan): cutaneous incisions were made on old scars several times using a knife. DISCUSSION The clinical presentation of scarification lesions and that of atypically healed wounds (presumably an effect of inflammation induced by the introduction of irritating foreign bodies such as sand, salt, etc.) are completely different: in all cases they indicate a relative timeframe of the facts, which the clinician should not overlook in reconstructing the patient's course and the injuries to which he has been subjected (hence the proposed designation of "palimpsest scar", in the sense that a palimpsest is a manuscript on a parchment that previously contained writing but has been scratched clean to be overwritten). Thus, a "palimpsest scar" constitutes a fresh scar on top of and hiding another (ritual) scar in a context of ethnic cleansing. The diagnostic and clinical significance comes from the importance of differentiating between ethnic-type lesions and those induced by physical violence and abuse in a context of war.
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Affiliation(s)
- P Charlier
- Laboratoire d'éthique médicale et de médecine légale (EA4569), université Paris-Descartes, 45, rue des Saints-Pères, 75006 Paris, France; CASH & IPES, 403, avenue de la République, 92000 Nanterre, France; UFR des sciences de la santé, UVSQ, 2, avenue de la Source-de-la-Bièvre, 78180 Montigny-Le-Bretonneux, France.
| | - F Bou Abdallah
- Laboratoire d'éthique médicale et de médecine légale (EA4569), université Paris-Descartes, 45, rue des Saints-Pères, 75006 Paris, France; Université libanaise, faculté des sciences médicales, Hadat, Liban
| | - Y Mostefai Dulac
- CASH & IPES, 403, avenue de la République, 92000 Nanterre, France
| | - S Deo
- UFR des sciences de la santé, UVSQ, 2, avenue de la Source-de-la-Bièvre, 78180 Montigny-Le-Bretonneux, France
| | - S Jacqueline
- UFR des sciences de la santé, UVSQ, 2, avenue de la Source-de-la-Bièvre, 78180 Montigny-Le-Bretonneux, France
| | - L Brun
- Service d'anatomo-pathologie, hôpital de Parakou, Parakou, Bénin
| | - C Hervé
- Laboratoire d'éthique médicale et de médecine légale (EA4569), université Paris-Descartes, 45, rue des Saints-Pères, 75006 Paris, France; CASH & IPES, 403, avenue de la République, 92000 Nanterre, France
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